{"id":22097,"date":"2022-06-28T04:40:24","date_gmt":"2022-06-27T20:40:24","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=22097"},"modified":"2022-06-28T06:23:54","modified_gmt":"2022-06-27T22:23:54","slug":"intensive-care-med%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%9d%8e%e7%bb%b4%e5%8b%a4%e6%95%99%e6%8e%88%e5%9b%a2%e9%98%9ftrace%e7%a0%94%e7%a9%b6%ef%bc%9a%e9%87%8d%e7%97%87%e6%80%a5%e6%80%a7","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=22097","title":{"rendered":"[Intensive Care Med\u53d1\u8868\u8bba\u6587]\uff1a\u674e\u7ef4\u52e4\u6559\u6388\u56e2\u961fTRACE\u7814\u7a76\uff1a\u91cd\u75c7\u6025\u6027\u574f\u6b7b\u6027\u80f0\u817a\u708e\u60a3\u8005\u7684\u514d\u75ab\u589e\u5f3a\u6cbb\u7597"},"content":{"rendered":"\n<p>ORIGINAL<\/p>\n\n\n\n<h1 class=\"wp-block-heading\">Immune enhancement in patients with predicted severe acute necrotising pancreatitis: a multicentre double\u2011blind randomised controlled trial<\/h1>\n\n\n\n<h3 class=\"wp-block-heading\">Lu Ke, Jing Zhou, Wenjian Mao, et al<\/h3>\n\n\n\n<h3 class=\"wp-block-heading\">Intensive Care Med 2022 Jun 17.<\/h3>\n\n\n\n<h3 class=\"wp-block-heading\">doi: 10.1007\/s00134-022-06745-7.\u00a0Online ahead of print.<\/h3>\n\n\n\n<h2 class=\"wp-block-heading\">Abstract<\/h2>\n\n\n\n<p><strong>Purpose:&nbsp;<\/strong>Infected pancreatic necrosis (IPN) is a highly morbid complication of acute necrotising pancreatitis (ANP). Since there is evidence of early-onset immunosuppression in acute pancreatitis, immune enhancement may be a therapeutic option. This trial aimed to evaluate whether early immune-enhancing Thymosin alpha 1 (T\u03b11) treatment reduces the incidence of IPN in patients with predicted severe ANP.<\/p>\n\n\n\n<p><strong>Methods:\u00a0<\/strong>We conducted a multicentre, double-blind, randomised, placebo-controlled trial involving ANP patients with an Acute Physiology and Chronic Health Evaluation II (APACHE II) score \u2265 8 and a computed tomography (CT) severity score \u2265 5 admitted within 7 days of the advent of symptoms. Enrolled patients were assigned to receive a subcutaneous injection of T\u03b11 1.6 mg every 12 h for the first 7 days and 1.6 mg once a day for the subsequent 7 days or matching placebos (normal saline). The primary outcome was the development of IPN during the index admission.<\/p>\n\n\n\n<p><strong>Results:\u00a0<\/strong>A total of 508 patients were randomised, of whom 254 were assigned to receive T\u03b11 and 254 placebo. The vast majority of the participants required admission to the intensive care unit (ICU) (479\/508, 94.3%). During the index admission, 40\/254(15.7%) patients in the T\u03b11 group developed IPN compared with 46\/254 patients (18.1%) in the placebo group (difference -2.4% [95% CI - 7.4 to 5.1%]; p = 0.48). The results were similar across four predefined subgroups. There was no difference in other major complications, including new-onset organ failure (10.6% vs. 15%), bleeding (6.3% vs. 3.5%), and gastrointestinal fistula (2% vs. 2.4%).<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/media.springernature.com\/full\/springer-static\/image\/art%3A10.1007%2Fs00134-022-06745-7\/MediaObjects\/134_2022_6745_Fig1_HTML.png?as=webp\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/media.springernature.com\/full\/springer-static\/image\/art%3A10.1007%2Fs00134-022-06745-7\/MediaObjects\/134_2022_6745_Fig2_HTML.png?as=webp\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/media.springernature.com\/full\/springer-static\/image\/art%3A10.1007%2Fs00134-022-06745-7\/MediaObjects\/134_2022_6745_Fig3_HTML.png?as=webp\" alt=\"\"\/><\/figure>\n\n\n\n<p><strong>Conclusion:&nbsp;<\/strong>The immune-enhancing T\u03b11 treatment of patients with predicted severe ANP did not reduce the incidence of IPN during the index admission.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>ORIGINAL Immune enhancement in patients with predicted  [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/22097"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=22097"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/22097\/revisions"}],"predecessor-version":[{"id":22098,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/22097\/revisions\/22098"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=22097"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=22097"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=22097"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}